The role of ultra-processed foods in the US diet

Recently published in Population Health Metrics, the paper- The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study- investigates the relationship between the energy contribution of ultra-processed foods in the US diet and its content of critical nutrients. In this guest blog, co-author Eurídice Martínez Steele discusses the implications of a diet heavy in ultra-processed foods, for our health, as well as the health of future generations.

Ultra-processed foods are formulations manufactured from lower cost sources of energy and nutrients (sugars, starches, oils, fats, protein isolates, added fiber, vitamins and minerals), as well as additives. They aim for hyper-palatability, long shelf life and high profits, while also enabling consumption anywhere and anytime.

The concept of ultra-processed foods was developed by our team at the University of São Paulo in 2009. Since then, this concept has been widely used in studies trying to understand the impact of ultra-processed food consumption on both dietary quality and non-communicable diseases.

Ultra-processed foods make up 57.5% of daily calorie intake in the US population.

Studying the US population seems especially important because as a nation, it has one of the highest consumptions of ultra-processed food in the world. Because of this, our study may be relevant for nations with ultra-processed food consumption on the rise, who still have a chance to revert the situation, both through measures to increase population information and awareness, and food environment regulatory policies.

I think this study is also interesting because it does not focus on the quality of specific ultra-processed foods, suggesting people should stop consuming a particular food item. Quite the opposite, as the study’s main conclusion is that decreasing the overall consumption of ultra-processed food strongly improves dietary quality. This is consistent with recently launched Brazilian and Uruguayan dietary guidelines, which recommend avoidance of all ultra-processed foods and advise consuming freshly-prepared dishes and meals based on unprocessed or minimal processed foods, complemented with small amounts of processed culinary ingredients and processed foods.

Reducing ultra-processed food consumption

Society as a whole needs to react and engage in reducing ultra-processed food consumption, as it is a battle that must be fought from several interconnected fronts. On one hand, the consumer must seek for healthier food choices and engage in cooking meals from scratch. At the other end, the food industry must strive to produce less ultra-processed foods in favor of processed or minimally processed foods.

In order for these to happen, governments must engage and gear the promotion of healthier diets through public policies as discussed in detail by Marion Nestle in her book “Food Politics”. This is especially true currently, as most consumers are uncommitted to healthy eating, while the food industry has limited barriers to producing the most profitable, but low quality, products.

Ultra-processed food aim for hyper-palatability, long shelf life and high profits.

Although governments must serve and take into account different interests, prioritizing public health rather than business seems a must. Governments can promote healthy eating using several strategies. Food labeling regulation is important to guarantee ingredients and their use being clearly displayed in branded food items.

In the US, websites such as Fooducate or the USDA Branded Food Products Database, are promising tools enabling consumers to gain acquaintance of what they are eating and opting for healthier food choices.

The taxing of products rich in added sugars and subsidizing the costs of minimally processed foods are other ways the government can support healthy eating.

The marketing of ultra-processed foods should also be regulated to avoid the use of misleading and unfounded health claims. It is especially important to restrict advertising targeted at children; particularly the marketing of ultra-processed foods at schools. Regulation of food choices offered in school breakfast and lunch programs and by corporate takeovers of school food service operations, including vending machines, is essential.

Although governments must serve and take into account different interests, prioritizing public health rather than business seems a must.

Food choices available in schools should be aligned with US Dietary Guidelines. Setting a good example at school is important, as children bring back home all they have learnt at school. Governments can also promote healthy eating through campaigns targeting the general public, as well as education at schools.

The displacement of unprocessed or minimally processed foods, and freshly prepared dishes, by ultra-processed foods is not only related to dietary quality but also additional environmental and social problems. For example, ultra-processed food production damages the environment through increased packaging, long transport routes, intensive breeding of animals, and the degradation and loss of soil caused by monocultures.

Furthermore, consuming ready-to-eat foods frequently comes hand in hand with a loss of culinary skills and customs, such as gathering to prepare and cook meals and eating together. Snacking in isolation ends up displacing traditional culinary habits. As Michael Pollan argues in his book “Cooked: A Natural History of Transformation”, regaining control of cooking may be the most important step an ordinary person can take to help make our food system healthier and more sustainable.

The good news is that there is a movement towards taking back the kitchen. For example, a recently posted blog from Harvard’s School of Public Health provides smart tips on how to plan and increase the amount of cooked meals, arguing that it may help save money, time and improve dietary quality. Though there is a long road ahead, decreasing the consumption of ultra-processed foods arises as a rational and effective way to improve dietary qualities.

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